On April 13, 2017, the Taiwan Centers for Disease Control (Taiwan CDC) announced this year’s first imported Zika case identified in Taiwan. The case is an over 20 Taiwanese male who resides in northern Taiwan. During mid-March and early April 2017, he visited Angola. During April 2 and 4, he subsequently developed symptoms, including fever, headache and fatigue. On April 5, when he developed rash, he sought medical attention in Angola. On April 6 and 7, he developed joint pain and muscle ache. After returning to Taiwan on April 10, he sought further medical attention the next day when his rash persisted. Based on his symptoms and travel history, the hospital collected specimens from the case for laboratory testing and reported the case to the health authority. On April 13, infection with Zika virus was confirmed in the case. Currently, none of the family members residing in the same household and his colleagues that he came into contact with have developed suspected symptoms. The local health authority has implemented various prevention measures and provided the case with relevant health education, including the “1+6 Principle”.

Since 2016, a total of 14 imported Zika cases have been identified in Taiwan and they respectively became infected in Thailand (4), Vietnam (2), Malaysia (2), Indonesia (1), Singapore (1), St. Lucia (1), St. Vincent and the Grenadines (1), Florida, the U.S. (1), and Angola (1). Since 2015, 79 countries, areas and/or territories worldwide have reported local outbreaks of Zika virus infection. The overall Zika activity in Latin America and the Caribbean region has continued to persist. Some countries, including Aruba, Curacao, Panama, Costa Rica, Paraguay and Peru, have observed an increase in the number of cases. Outbreaks in other countries have remained at a plateau or declined. Singapore has recently reported sporadic cases, including 2 clusters that occurred at Simon Place and in the Flower Road and Hendry Close area.

Taiwan CDC has issued a travel notice of Level 2: Alert for Zika virus for 61 countries and territories with ongoing outbreaks or possible local transmission of Zika virus, including Singapore, Maldives and Angola. Moreover, 18 countries, including Indonesia, Thailand, Bangladesh, Cambodia, Laos, Malaysia, the Philippines and Vietnam, had previously reported Zika outbreaks. Although no Zika cases have been recently reported in those countries, no evidence has suggested that the local transmission of the virus has been interrupted. Hence, Taiwan CDC has issued a travel notice of Level 1: Watch for Zika virus for those countries.　　

Current scientific evidence has proved that Zika virus infection is usually mild in adults and suggested the occurrence of congenital microcephaly and even deaths in babies of mothers who were infected with Zika virus while pregnant. Therefore, pregnant women and women planning pregnancy are advised to postpone all unnecessary travels to Zika-affected areas. Travelers visiting Zika-affected areas are urged to take precautions against mosquito bites such as wearing light-colored clothing, long sleeves and long pants, applying officially approved mosquito repellent to exposed parts of the body, staying at accommodations installed with window screens, screen doors or air conditioners. In addition, travelers leaving Zika-affected areas are urged to follow the “1+6 Principle” to prevent Zika transmission. The “1+6 Principle” specifies that people who have recently traveled to Zika-affected areas should monitor their own health and take precautions against mosquito bites for at least 3 weeks, postpone blood donation for at least 1 month, and regardless whether they develop suspected Zika symptoms, they should practice safe sex for at least 6 months to prevent Zika transmission. Further, female travelers should postpone pregnancy for at least 6 months.　

Travelers returning to Taiwan from Zika-affected areas are urged to proactively contact the quarantine officer at the fever screening station at the airport when experiencing symptoms. If symptoms develop within two weeks of their return, please seek immediate medical attention and inform the physician of their travel history. Simultaneously, healthcare facilities are urged to heighten vigilance for suspected cases, inquire patients of their travel history when necessary, and report suspected cases to the competent health authority as required by the law in order to lower the risk of transmission. For more information, please visit the Taiwan CDC website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922 (or 0800-001922).